How the 2010 Law Allocates Funds for
Medicare and Medicaid
At Home Elder Care and
Disability Care Programs:
Extends Medicaid Money Follows the Person (MFP)
Rebalancing Demonstration program
through September 2016.
The MFP program was authorized
in the Deficit Reduction Act of 2005
to encourage states to transition
Medicaid enrolled individuals from
nursing homes to the communities.
The Medicaid coverage follows the person
to the community and pays for
the home and community-based services.
Community First Choice Option
• Establishes the Community First Choice Option,
a state plan option to provide community-
based attendant supports
and services to individuals with disabilities
who are Medicaid eligible and who require
institutional level of care.
These services and supports include
assistance to individuals with disabilities
in accomplishing activities of daily living
and health related tasks
States that choose Community First Choice Option
will be eligible for an enhanced federal match rate
of an additional six percentage points
for reimbursable expenses in the program.
.
Long-Term Care
• Establishes the Community Living
Assistance Services and Supports
(CLASS) program,
a new national long-term care insurance
program funded through voluntary payroll
deductions,
which will provide a cash benefit
to individuals who are unable to perform ADLs
for the purchase of community living assistance
services and supports.
Care Coordination
• Creates the Independence at Home demonstration
program to provide high-need Medicare
beneficiaries with primary care services
in their homes and allow participating
teams of health professionals
to share in any savings if they reduce
preventable hospitalizations,
prevent hospital readmissions,
improve health outcomes,
improve the efficiency of care,
reduce the cost of health care services,
and achieve patient satisfaction.
• Eliminates Medicare Part D
prescription
co-pays
for full-benefit "dual eligible" beneficiaries
who are receiving at home and
community-based services.
Click for At-Home Care Resources
Adaptive Clothing
Aging in Place Design Checklist
Elder Care Forums
Examples of Kitchens and Bathrooms
Long Distance Care Givers
MassAccess Accessible Housing
Ten Tips to Make Your Home Safer
Alzheimer's Association Publications
AARP Healthy@Home Technologies
AARP Universal Design Resources
SafeLink Free Cell Phone Service
Aging in Place
Click for Information on
Income Tax Deductions for
At Home Care
Income Tax Deductions for
At Home Care
• Senior Care Options
Combining Medicare and MassHealth
1-888-885-0484
Read Part II of MassHealth and You
The Ways & Means Committee of the Massachusetts State Senate announced a proposed budget on May 19, 2010 that increases the Department of Elder Affairs Purchased Services account. The account will be funded at $103.251 million, which is approximately $3 million more than the House of Representatives has budgeted. This increase in budget would help reduce the waiting list for home care services.
How much is finally budgeted for at-home care depends on a Conference Committee, where three members each of the House and Senate resolve the differences in their budgets. Items that are identical in both budgets will remain in the final budget, along with compromises worked out by the conferees.
a legislative anayst with the Massachusetts Chapter of the National Academy of Elder Law Attorneys views the budget result for elder home care as "essentially level funded for the coming budget year" that begins July 1. The Executive Office of Elder Affairs had notified Greater Springfield Senior Services last year that most new applicants for Home Care Services would have to be placed on a Waiting List. Read Explanation Letter from GSS. Case Managers have continued to make home visits to determine an elder's eligibility for Home Care Services.
The proposed budget includes $1 million more for the Department of Elder Affairs Case Management account. The $37.165 million account pays for the home care case management program. The Elder Affairs Protective Services account would also be increased to $16.733 million, approximately $1.5 million more than the House budget. This account provides services for elders at risk, guardianship, protective services case management and money management services.
A first step toward qualifying for several at home programs offered by Medicaid is the MassHealth Frail Elder Waiver:
Income Limit: $1,869/month (could be twice that for married people)
Asset Limit: $2,000 (flexible asset transfer rules)
Care Need: frail enough to need nursing home level of care for personal care needs
Eligibility Decided: By filing a MassHealth Senior Benefits Request form and evaluation by the Aging Services Access Point that serves your town.
After qualifying as a Frail Elder, you can have access to the Medicaid programs listed here.
• Adult Family Care Program:
A family member (son or daughter) hosts
an elder in their home, or comes to live
in the elder's home.
To qualify you must need help with
Activities of Daily Living, but still have
the mental capacity to call 911 for help
if needed. MassHealth will make monthly
payments to the family member of
up to $18,000 per year.
Payments to the family caregiver are
not subject to income taxes.
• Community Choices Program:
Provides home care services to people
who need 24 / 7 care for physical frailty
or cognitive impairment,
are unable to administer medications,
and require assistance and supervision
with Activities of Daily Living.
The Aging Services Access Point (ASAP)
for your city or town sends a nurse
to determine a care plan for you. Find ASAP for your town.
• Personal Care Attendant Program:
Home care services for people who
need daily assistance with bathing,
dressing, cooking and other
Activities of Daily Living.
After your physician makes a referral,
your Aging Services Access Point (ASAP)
assigns a nurse to determine a care plan.
These services can be provided in your home,
or at an Assisted Living Facility. Find ASAP for your town
Click here for: Fact sheet on on each program, containing more details about services and your potential eligibility. But remember, any benefits you receive can become subject to Estate Recovery. We can explain whether Estate Recovery will be a problem in your case, and ho you and your family can avoid estate recovery.
We can help families find ways to provide at-home elder care that will work for the elder and the rest of the family. We have information on MassHealth, Veterans Aid and Attendance, and other programs.
For the home care option to succeed, it's important that you carefully plan to meet medical and care giving needs. We can help you make sure that a family member, or other trusted person, has the legal authority and direction, as expressed in the elder's durable power of attorney and health care proxy. This surrogate decision making authority is especially important to managing a home care plan.
Click Here to view our slide show on
Long Term Care Planning at Home.
Hear how our client
Protected Independence
and Preserved Assets.
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At-home care requires assistance from family members who are willing to devote the time and attention. We can help you prepare a written caregiver contract that can preserve family harmony and protect eligibility for MassHealth / Medicaid. The written contract can manage everyone's expectations of the care giving needs that are met by a particular family member. This prevents arguments between a care giver child and other brothers or sisters who are not actively involved with providing the care.
If you are planning an extended commitment to care giving, be sure to look at all the effects on your own finances, now and in the future. The National Center on Caregiving says that women who provide long-term care often suffer serious long-term financial consequences (including reduced Social Security, pension and retirement income) because of reduced time in the workforce. Additional leave taken from the workforce to care for young children, as well as the expenses of elder care, can multiply the family's financial problems.
The National Family Caregivers Association has resources for family caregivers, including the advice that you don't allow your loved one's illness or disability to always take center stage. "Remember to be good to yourself, especially since you're doing a very hard job. You deserve quality time, just for you. Watch out for signs of depression, and don't delay in getting professional help when you need it. When people offer to help, accept the offer and suggest specific things that they can do. Educate yourself about your loved one's condition. Information is empowering."
